Palpitations – colloquially called heart palpitations – (synonyms: Herzstolpern, Palpitatio cordis; Palpitationen; Palpitations of the heart; Unpleasantly perceived heartbeat; ICD-10 R00.2 -: Palpitations) refers to heart actions that are perceived by the affected person himself as unusually fast, forceful, or irregular. They can occur intermittently (with interruptions) or persistently.
In up to 43% of cases, the cause is cardiological (affecting the heart), and in about 30%, the cause is psychological.
Palpitations can be a symptom of many diseases (see “Differential diagnoses”).
Frequency peak: The symptom occurs predominantly in the 3rd and 4th decade of life.
The prevalence (disease frequency) is 10-25% (in Germany). Palpitations, along with thoracic pain (chest pain) and dyspnea (shortness of breath), are among the most common symptoms in general medical and internal medicine practices.
Course and prognosis: Palpitations can be harmless, but they can also have a pathological value. To exclude the latter, further diagnostics are required. For example, palpitations occur in the context of hyperthyroidism (overactive thyroid) or hypoglycemia (low blood sugar), but can also be caused by alcohol consumption, drugs and medication. If three of the following four variables, which are independent predictors (predictive variables), are true in the individual, the risk for the presence of a cardiac cause is 71%:
- Male sex
- Description of an irregular heartbeat
- History of heart disease
- Duration of palpitations for at least five minutes
If a heart disease is present, such as heart failure (cardiac insufficiency), coronary artery disease (CAD; coronary artery disease) or vitia (valvular heart disease), a cardiological control examination and, if necessary, optimization of therapy should be made.
If nocturnal heart stuttering occurs in younger and otherwise healthy persons, it is often a harmless functional rhythm disturbance. Regardless, a thorough history (cardiac death in the family?, dyspnea (shortness of breath)?, syncope (brief loss of consciousness)?) should be obtained and ECG documentation (long-term ECG) should be performed. Most often, supraventricular or ventricular extrasystoles (heartbeats occurring outside the physiologic heart rhythm; originating in the atrium or ventricle) will be seen; occasionally, nighttime paroxysmal atrial fibrillation (seizure-like cardiac arrhythmia with disordered activity of the atria).
Notice: If you have palpitations with shortness of breath, dizziness, chest pain, or fainting, have someone drive you to an emergency room immediately or call your local emergency number. These may be signs of a serious heart problem.
